Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (565 page)

   Urinary acidification capacity can be altered, resulting in renal tubular acidosis.

   Renal failure occurs in approximately 5–18% of SCD patients.

   Papillary necrosis, renal infarction, and renal medullary carcinoma can develop in affected patients.

Suggested Reading

Da Silva GB Jr, Libório AB, Daher Ede F. New insights on pathophysiology, clinical manifestations, diagnosis, and treatment of sickle cell nephropathy.
Ann Hematol.
2011;90(12):1371–1379.

   
KIDNEY TRANSPLANTATION

   Overview

   Kidney transplantation is the most effective form of renal replacement therapy and treatment of choice for end-stage renal disease.

   It has been recommended that transplantation should not proceed unless the measured or calculated GFR is <20 mL/minute, and there is evidence of progressive and irreversible deterioration in renal function over the previous 6
–
12 months.

   Initial evaluation of potential kidney recipients and living donors includes medical and surgical history, physical examination, chest x-ray and imaging studies, electrocardiogram, and laboratory testing.

   Laboratory Evaluation of Recipients and Donors

   ABO blood type and HLA typing.

   Urinalysis and urine culture, GFR, and protein excretion.

   Serologic testing for HIV, HBV, HCV, HAV, cytomegalovirus, Epstein Barr virus, herpes simplex virus, varicella virus, and syphilis testing.

   Other laboratory tests include CBC, electrolytes, BUN, creatinine, uric acid, albumin, calcium, phosphorus, lipid panel, and liver function tests.